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1790023802
TIMOTHY GANG
AMITYVILLE, NY
NPI
1790023802
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 25069-T)
Enumeration Date
2013-01-24
Last Update Date
2013-01-24
Business Address
-- TIMOTHY GANG
400 SUNRISE HWY CARONE HALL
AMITYVILLE, NY 11701-2508
Phone number: 631-608-5022
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Mailing Address
-- TIMOTHY GANG
400 SUNRISE HWY CARONE HALL
AMITYVILLE, NY 11701-2508
Phone number: 631-608-5022
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